Ophthalmic Plastic & Reconstructive Surgery

Dr. Vidor is a fellowship trained ophthalmic plastic and reconstructive surgeon. He is one of a select group of surgeons who have completed a prestigious fellowship accredited by the American Society of Ophthalmic Plastic and Reconstructive Surgery. He provides comprehensive evaluation and treatment for diseases and disorders of the eyelids, eye socket, tear ducts, eyebrows and mid-face.

Eyelid Diseases and Disorders

Blepharoplasty

Ptosis Repair

Ectropion Repair

Entropion Repair

Lid Retraction Repair

Eyebrow Disorders & Brow Lift

Tearing Disorders & Tear Duct Surgery (dacryocystorhinostomy)

Thyroid Eye Disease

Orbital Decompression

Lid Retraction Repair

Eyelid and Socket Cancer

Tumor Removal

Eyelid Reconstruction

Socket/ Orbital Reconstruction

Mohs Micrographic Surgery

Orbital Fracture Repair

Enucleation/ Evisceration

Eyelid Diseases and Disorders

The eyelids provide a critical role in maintaining good vision and the health of the eye. The eyes are also the focal point of the face and droopy eyelids and excess skin can interfere with vision and caused a tired appearance. The upper eyelid itself may be sit too low (ptosis) or there may be too much skin (dermatochalasis) or both. Both conditions are usually due to age, but rarely can be caused by a medical disease of the nerves and muscles or trauma.

Droopy lower lids and can turn in (entropion) or out (ectropion) and cause tearing, burning, and red eye as well as give an aged appearance. They can also cause the eyelashes to rub the eye (trichiasis) resulting in an abrasion. Overly tight eyelids (lid retraction) may also cause watering, pain, and irritation. Like the upper lids, age usually causes these problems, but trauma, tumors, thyroid disease, Bell’s palsy (or seventh nerve palsy), and sun damage can also cause the lower lids to be in the incorrect position.

Surgical correction (eyelid lift/lid lift, including; blepharoplasty, ptosis repair, ectropion/ entropion/ lid retraction repair) can often improve these symptoms as well as provide a rejuvenated appearance. Surgery is usually performed on an outpatient basis with most patients returning to normal activity in about a week.

Pre-operative: Bilateral upper lid Blepharoplasty

Post-operative: Bilateral upper lid Blepharoplasty

Pre-operative: Bilateral upper lid Blepharoplasty

Post-operative: Bilateral upper lid Blepharoplasty

Eyebrow Disorders

Like the upper lids, the eyebrow can sag as well. This can also interfere with vision and cause an aged appearance. This may be due to the brow hanging low, loss of eyebrow volume or deflation, or both. Surgical correction (brow lift) can help improve the visual field and appearance. A nonsurgical “brow lift” can sometimes be achieved by adding more volume to the area.

Tearing Disorders and Tear Duct Diseases

The tear ducts run from the corner of the eyelid down through a bony duct and empty into the nose. They may become blocked (nasolacrimal duct obstruction or “blocked tear duct”) or infected (dacryocystitis) and cause excessive tearing. A detailed tear duct examination can determine if and where a blockage is present.

If the tear duct is blocked in an adult, surgery is often necessary to prevent tearing and infection. Children with a blocked tear duct usually do not require surgery, but may need a “stent” placed in the tear duct. Tear duct surgery redirects the flow of tears around the blockage so they drain properly (dacryocystorhinostomy). Tear duct surgery is usually performed as an outpatient procedure and takes about an hour. Most patients can return to work in about a week.

Thyroid Eye Disease

Thyroid disorders may cause eye problems. This condition is often referred to as thyroid eye disease, Graves’ disease, thyroid ophthalmolopathy, or thyroid orbitopathy. Typically, the eyes, lids, and socket are affected when thyroid levels are too high, as in Graves’ disease, but can occur when thyroid levels are too low, or even normal. Bulging eyes (proptosis or exophthalmos), wide eyes (lid retraction), double vision (diplopia), swelling of the eyes and lids, tearing, and irritation are common eye problems that can be related to thyroid disease. Rarely the disease can be severe enough to cause vision loss.

Thyroid eye disease can be treated with medicine and/or surgery. Corticosteroids can help to calm the disease down. Surgery can be performed to decrease eye bulging (orbital decompression), correct double vision (strabismus surgery), and fix the wide eyed “thyroid stare” (lid retraction repair).

Eyelid and Socket Cancer

Skin cancer can develop anywhere on the body and the eyelids are no exception. Most eyelid cancer is caused by the sun. A biopsy should be performed for any suspicious growth to determine if it is cancerous. Basal cell carcinoma is the most common eyelid cancer, but other types such as squamous cell carcinoma, melanoma, and sebaceous cell carcinoma can occur. Cancers should be completely removed and eyelid reconstruction performed immediately after. The eyelids are an extremely delicate and intricate area and reconstruction should be performed by an eyelid expert.

Signs that a lump or bump may be cancerous include:

Recent growth

Bleeding

Eyelid notching

Eyelash loss

Cancer of the socket is rare but does occur. The type of treatment is dependent on the type of cancer. Biopsy or surgery may be necessary. Reconstruction of the eyelids and area around the eye should be performed by a specialist who has formal training in orbital surgery, such as Dr. Vidor.

Mohs Micrographic Surgery for Skin Cancer

More than two million Americans will receive a diagnosis of skin cancer this year. A predominant number of these diagnoses reveal the skin cancer to be located in the facial region, which can be disfiguring. There is hope for these patients. The surgical technique known as Mohs, a micrographic surgery for skin cancer developed by Dr. Frederick Mohs in the 1930’s, is the most effective procedure for expunging Basal Cell Carcinoma and Squamous Cell Carcinoma.

This technique has shown significant cure rates. The success of this surgery is related to the excision of cancer cells while sparing a significant amount of healthy tissue. In addition to the success rate of Mohs surgery, it is also a safe procedure. The surgeon can tailor the surgery to the exact dimensions of a lesion, thereby reducing the site of the wound which leads to successful post-operative healing. Dr. Vidor works with some of the region’s top Moh dermatologists in a team approach to removing and reconstructing eyelid cancer.

Pre-operative: Bilateral upper lid Blepharoplasty

Post-operative: Bilateral upper lid Blepharoplasty

Orbital Fractures

An orbital fracture (sometimes called a “blow out fracture”) occurs when the bones of the eye socket are broken. They are typically caused by trauma. Orbital fractures can cause swelling around the eye, double vision, pain, facial numbness, and can cause the eye to appear to “sink into” the socket. A detailed facial and eye examination should be performed by a specialist to determine the extent of injuries. A CT scan is an important test used to evaluate orbital fractures, and if already performed, should be brought with you to your consultation.

If an orbital fracture is large or causing double vision then surgery is usually recommended. It is often advisable to wait a week or two for the swelling to improve prior to surgery, unless an eye muscle is caught in the fracture. The broken bones can be bridged by a synthetic plate and held together with micro plates. Most of the time, the surgical incision can be placed on the inside of the lid to prevent a scar from forming on the eyelid skin.

Enucleation/Evisceration

In special circumstances it may be necessary or beneficial for a patient to have an eye removed. The procedure performed is either an enucleation or an evisceration. There are two main reasons a patient may need this; a malignant tumor in the eye, or a blind eye that has intractable pain.

The procedure involves removing either the whole eye (enucleation) or the inside contents of the eye (evisceration), and placing an implant in the socket. The procedure takes about an hour and is done under general anesthesia. Many patients with a blind painful eye get pain relief within a few days. After a few weeks, a prosthesis is made that matches the other eye. The prosthetic eye looks natural and moves well in most patients.